The Lt. Governor of Missouri, Medicare service provider SynCare last month.(Rep) has recently called for action from Gov. ’s (Dem) administration to address the backlog of home-care senior service needs, after the state cancelled a contract with
The state’s contract with SynCare was cancelled after it was discovered that the company was unable to handle the significant amount of home health care cases passed their way. Since Missouri and Syncare ended their contract, the state has hired 130 temporary workers in an effort to address the backlog of nearly 9,300 cases.
“When problems arose with the contract, the Administration ignored the problems, putting some of Missouri’s most vulnerable residents – seniors and disabled people needing in-home healthcare – at risk.” Said Kinder, at least partially motivated by his upcoming challenge of Nixon for governor no doubt. But the SynCare case brings up important issues, such as the general lack of capacity for the coming wave of demand for home health services.
At Med Plus HealthCare we are obviously strong advocates for benefits of home health care, understanding that medical and rehabilitative care given in the comfort and safety of the patient’s home results in far better clinical outcomes than other settings. We also know that the overall costs associated with providing care in the home are lower than nursing home and in-patient care. This is a critical benefit when considering the number of aging Baby Boomers, living longer and more independently than ever before, and the strain they will put on an already taxed health care system in the U.S.
The situation with SynCare serves as a highlight of the growing emergence of home health care services and the preparation that States and the Federal Government need to begin making to accommodate the tidal wave of home health patients that is coming over the next 2 decades.
Med Plus HealthCare we advocate for an increased focus on public education regarding the subject as well as a better understanding from our elected officials to acknowledge the tremendous benefits of providing in home therapies, medical care and social services to seniors. Only then can the States and their local governments avoid situations like those occurring in our home state of Missouri right now.
Med Plus Healthcare, a leader in the St. Louis home healthcare industry, is one just one business that is active in encouraging our fellow citizens to contact their congressmen and senators to oppose any deficit reduction proposals that would require a home health care copayment for Medicare beneficiaries, or accelerate the $40 billion in home health care payment cuts in the Patient Protection and Affordable Care Act.
Right now there are more than 3 million senior citizens and disabled Americans who are enrolled in Medicare and rely on home health care services, a number that is sure to grow in coming years. This Medicare home health care benefit for St. Louis residents and those across the whole country allows these individuals to receive quality, affordable health care in the comfort of their homes, with better clinical outcomes, rather than a more costly hospital or nursing home setting.
Copayments and additional payment cuts would be devastating to access to care for home health care patients. Copayments are in effect an inefficient and regressive “sick tax”. This burden would fall most heavily on the oldest, sickest and poorest of Medicare beneficiaries; the ones who can least afford it.
About 86 percent of home health care users are 65 or older, with 70 percent being 75 or older. More than 60 percent of all users are women.
Home health care users are poorer, on average, than the Medicare population as a whole — 58 percent are below 200% of the federal poverty line, compared with just 41% of all Medicare beneficiaries.
The copayment for three episodes (an episode equals a 60-day period) would consume almost 3 full percentage points of the annual income for a beneficiary at 150% of the federal poverty line.
Studies show that low-income beneficiaries typically perceive copayments to be a significant financial burden. This caused Congress to eliminate home health care copayments in 1972 to encourage the use of less costly and more effective health care services. Increasing out-of-pocket medical expenses for the elderly and the disabled discourages individuals from seeking this more affordable, necessary care and forces them to seek care in more expensive institutional settings, thus increasing the overall cost to society in general.
The bottom line is that the greatest impact of this “sick tax” would fall on the oldest, sickest Medicare beneficiaries – those who already spend a significant percentage of their income on health care needs.
And home health care patients and their families and other loved ones are paying a huge copayment already, by providing an estimated $375 billion in unpaid care in the home, costs that would be incurred by Medicare if these patients were in a hospital or nursing home.
At Med Plus Healthcare, we ask that you stand up and have your voice heard to preserve access to home health care services by contacting your representatives and insisting they reject home health care copayments, and any acceleration of the scheduled home health care payment cuts.
In the news recently was the story about healthcare providers in St. Louis and throughout Missouri have asked top government officials in Jefferson City to sever ties with SynCare LLC, a vendor tasked with providing home health services for the state.
Critics allege that the company failed to meet its obligations to Missouri’s 50,000-plus Medicaid recipients. These groups state that the company “failed to meet the terms and intent of its contract with the Missouri Department of Health and Senior Services from the very beginning”, and then added that “recent news coverage hardly scratches the surface of the problems being experienced by clients and providers across the entire state.”
Former clients, providers and patient advocates have joined with both current and former SynCare employees in criticizing the company for placing Medicare and Medicaid recipients on hold for hours on end when they contact the call center with concerns about decisions in-home health questions.
SynCare also stands accused of not furnishing required paperwork in a timely fashion and allowing days and sometimes weeks to pass before assessing the needs of clients requiring in-home services.
This type of shameful behavior by an in-home healthcare provider can (sadly) lead some people to view home healthcare in a negative light, and not realize the tremendous benefits of receiving medical and therapy services in the home.
Med Plus Healthcare works very hard, each and every day, to provide the absolute best medical and social service care, with the best possible outcomes, in the home setting.
Unlike out-of-state providers such as SynCare (based in Indianapolis), at Med Plus all of our patients using our home healthcare services in St. Louis can easily reach one of our representatives, or contact me directly if they have a problem, concern or questions about their care. In addition to having the most trusted, skilled in home therapists in St. Louis and throughout Missouri and Illinois that communicate with your Doctors and follow their instructions precisely, as well as staff that can help handle payment from insurance or Medicare, this is just one more of the ways that we separate ourselves from the competition.
Rick Rief, President/CEO Med Plus Healthcare
The House of Representatives has voted 269-161 to pass a bill that would raise the nation’s debt limit while cutting trillions of dollars from federal spending. This 11th hour deal for raising the debt ceiling will have major effects on the future course of U.S. spending, not just for the economy as a whole, but healthcare in particular.
The plan — finally agreed upon Sunday evening July 31st after weeks of tense negotiations — would raise the $14.3 trillion federal debt ceiling by another $2.4 trillion, while cutting federal spending by at least $1.5 trillion.
The bill would initially increase the debt limit by $400 billion and establish procedures to allow the limit to be raised further in two steps for a total increase of $2.4 trillion. That’s enough for the nation to meet its debt obligations through the beginning of 2013.
Democrats fought for a plan that wouldn’t include any cuts to Medicare, Medicaid, or Social Security, but the final deal just signed wouldn’t shield Medicare from cuts.
The bill would create a new 12-member bi-partisan committee that will be tasked with agreeing on $1.5 trillion additional in cuts over 10 years and presenting it to Congress by Nov. 23. If the committee can’t come to an agreement on what to cut, automatic cuts of as much as $1.2 trillion would then kick in in 2013, half of which would come from domestic spending.
If the special committee fails to identify agreed-upon cuts, then automatic cuts would likely target Medicare, and providers would be the prime target. Under the bill, any potential Medicare cuts wouldn’t come from charging beneficiaries more; rather, the savings would come from paying providers — doctors and hospitals — less for treating Medicare patients.
In the health policy community, opponents of the plan pointed to the fact that Medicare already reimburses less than private insurers, and that doctors are already facing a 30% cut in their reimbursement come Jan. 1.
Anticipating being the target of future cuts, the Federation of American Hospitals voiced its disapproval of the plan even before the House took a vote.
“We appreciate the pressing fiscal need to reduce the federal deficit and raise the national debt ceiling,” said Chip Kahn, CEO of the Federation of American Hospitals in a press release sent Monday afternoon. “However, we cannot support the Budget Control Act of 2011 because it sets in motion billions of dollars in arbitrary Medicare funding cuts. Arbitrary hospital payment reductions imposed for fiscal reasons are unwise and will impact caregivers and the beneficiaries they serve alike.”
In this fiscal environment, home health care in St. Louis and everywhere has never been more vital to the nation. With lower total costs compared to full time care or nursing homes, and better medical outcomes, in home medical care and therapy will be a crucial component of lowering the healthcare costs in the US.
This need to lower costs becomes even more apparent when considering that 10,000 Baby Boomers reach retirement age every day, and will continue to do so for the next 19 years. A serious discussion on the ever-increasing importance of home healthcare, the medical outcomes it produces, and the ability to spend less while allowing patients to remain in the security and comfort of their own homes will need to take place if there will be any hope of reining-in runaway healthcare costs.
Unfortunately you hear the stories in the news all too often, about a senior being taken advantage of by their home healthcare provider or not receiving the assistance that they should.
Sometimes the situation arises out of simple neglect or inexperienced home health therapists and aides. Other times there is malicious intent by a home healthcare provider, resulting in outright abuse or criminal action against the vulnerable patient, financial loss or other situation that results in serious negative or even catastrophic consequences for you or your loved one.
It doesn’t matter of course if you are looking for home healthcare services in St. Louis, Missouri, Illinois or anywhere else – knowing the full background and expertise of those healthcare and social service professionals in the home setting is always CRITICAL.
Some agencies take the easy route, but not top-notch providers such as Med Plus Healthcare. We make sure that every employee has an extensive background check, and is checked through the Family Care Safety Registry (FCSR) as well as the Employment Disqualification List (EDL) before they provide care to you or your loved one.
We also have many recruiting efforts that ensure that our new staff members are the best in their fields of expertise at Med Plus Healthcare, such as word of mouth from other employees and healthcare professionals. In addition, our President Rick Rief speaks at many public events and colleges throughout the year, where he has met and hired several stand-out staff members. In this way, we ensure that we only employ the best…folks that you or your loved ones can trust and feel comfortable with in your home.
Gov. Deal wrote an open letter to House Speaker John Boehner (R-Ohio) urging him not to impose co-payments on home healthcare services covered by Medicare and Medicaid. The co-pays are included in a list of Medicare cost reductions that House Majority Leader Eric Cantor (R-Va.) brought to recent White House negotiations.
The new policy, just one small part of a far larger struggle between Republicans, Democrats and President Obama, coupled with cost-sharing for nursing homes and cuts to payments for post-acute care, contends it would “save $50 billion over 10 years”, according to the document.
However, critics contend that a co-payment requirement would cause a shift of thousands of lower-income seniors out of home-based care into much more costly nursing homes, and impose billions of dollars in additional Medicaid costs onto the states. This would affect millions of home healthcare recipients in St. Louis, Missouri, Illinois and everywhere else across the nation.
Some policy experts say these co-payments can help drive healthcare costs down by cutting down on “overutilization” of services. But the truth is that the cuts would disproportionately affect poor sick people, shift patients to more costly settings such as nursing homes, and actually increase Medicare and Medicaid costs – not lower them.
And the many opposed to the new rules also point out that such co-pays are quite unpopular and were repealed in 1972 after originally being included in the 1965 Medicare law.
Whether a deal is reached on the upcoming debt ceiling or what it will ultimately look like is anyone’s guess at this point. But at Med Plus Healthcare, we know as many others do that home healthcare is one significant way that overall healthcare costs can be reduced in the U.S.
With a huge wave of Baby Boomers reaching retirement age and beyond, we think it’s critical that in home medical care and rehabilitative therapies be considered when compared to more expensive full-time nursing home care. Every patient situation is unique, and every potential healthcare solution has its place, but home healthcare can produce the best medical outcomes, in the safety and comfort of home, at the least cost to both the individual and the healthcare system.
You most likely have seen a significant rise in the age of your overall patient population in the last 10 years or so. In fact, the statistics show that the senior population will steadily grow over the next few decades, and reach 80 million by the year 2050. And according to data from the AARP, 82% of people said that they would prefer to stay in their homes as long as possible, much preferred over the other options of hospitalization or living in a retirement community. However, it has become impossible for many working families to provide the adequate care that their elderly loved ones need in the home. This has created remarkable interest and growing demand during the decade in home healthcare for seniors.
Home Health Care services like those offered from Med Plus Healthcare are quite flexible, and care givers can work for a few hours a week all the way up to offering 24-hour care in a home setting.
Of course, there are many considerations involved with both your patients and also their loved ones when choosing between a nursing home and home health care. These concerns can be based upon the seriousness of the condition, and how much care is needed for the affected individual. But a facility is often not necessary, and in-home care allows these senior citizens to maintain their independence and peace of mind in the comfort of their own home, with less expense, and usually with better patient outcomes and quality of life than other options.
As the home healthcare option becomes more and more mainstream, the number of questions that you will probably experience from patients and families will only continue to grow.
Here are a couple of the most common concerns and myths about home healthcare voiced by patients:
1. I don’t need homecare if I can’t meet a 4-hour minimum
If an individual needs care, whether it’s for just one hour or all 24, at Med Plus Healthcare we have options to provide what they need. We understand that everyone’s situation is specific and unique, and different people have different needs. But not all providers have a no-minimum policy, and some providers also do not recognize these unique differences between their clients, so it’s important to your patients to find someone who does, like Med Plus Healthcare.
2. If my family is already helping, there is no need for additional care
People who are physically or emotionally exhausted or guilt-ridden because of their own shortcomings simply cannot provide the best care. According to the research provided by the Harvard Medical School Family Health Guide, family caregivers should neither expect nor try to be “on-call” 24 hours a day. Every caregiver needs respite and periods of relief.
3. If I can’t do my own shopping and housework, I just shouldn’t do these activities anymore
Everyday tasks, like dishes, vacuuming or rearranging the basement or cleaning the garage, can be quite tedious for a senior with arthritis. Basics, such as organizing a closet, can be extremely exhausting for a cancer patient. These tasks are never ending and, if they become more difficult during post-op, or due to treatment or age-related conditions, they can take precious time away from patients in an already very busy schedule. But completion of these tasks is necessary for a high quality of life for your patients. When even the most basic daily tasks become overwhelming, or loved ones just need a helping hand, a qualified care provider is the best option to step in and help.
4. Until I know exactly what services I need, I don’t need in-home care
Patients don’t need to know what care they need up front, that’s what qualified homecare professionals like Med Plus Healthcare are here for. Starting with our thorough assessment process, our experience R.N.’s offer evaluation and oversight on every case we handle, to ensure all that your patient’s needs are completely accounted for and your Plan of Care is followed precisely. And because of our service providers spend so much time dedicated to individual clients, they can help these patients plan ahead – since most patients find it difficult to know how or when their future needs may change.
5. I may need homecare, but it is unsafe to invite a stranger into my home
Safety is always a legitimate concern for seniors, especially considering the relatively rare but highly sensationalized stories that highlight patient abuse or breaches of trust. But from a security standpoint, when your patients deal with a well qualified, highly respected and reputable agency such as Med Plus Healthcare, this can provide the peace of mind and feeling of safety for patients and families when they arrange for help in the home setting.
From a medical/patient outcomes standpoint, various studies show that in home care can be safer than the alternatives, and not only because of the one-on-one care. One recent study indicated that about half of infections could be linked directly to hospital care. Another study reported that, given they are seeking the appropriate treatment for their condition, patients with chronic heart disease fare much better at home compared to the hospital. And, ultimately, remaining home can be less stressful because it is familiar, which fosters a sense of comfort and calmness for your patients.
There comes a time for most ailing seniors to decide if they want home care or want to be in a nursing home. When factoring in the many benefits of staying in their own homes, added with the stress and apprehension of moving to a new home or facility (difficult at ANY age), it’s easy to understand the exploding demand for home healthcare. At Med Plus Healthcare, we wish to be a valued and trusted partner and resource for you and your staff – to provide your patients with the absolute best therapy and daily assistance options, following your orders precisely; and treating them with the high level of respect for their dignity and wellbeing that they deserve. We hope you will explore partnering with us to provide high quality care to your patients in the future.
Rick Rief, President and CEO – Med Plus Healthcare
Med Plus HealthCare is St. Louis’ premier home care agency, a Medicare and Medicaid-certified organization serving the health care needs of area families for more than five years. We have referral relationships with over 300 physicians and healthcare facilities, and serve patients in 32 Missouri and Illinois counties, typically within twenty four hours of a patient referral.
Partnering with a home care agency and health care professional to care for a loved one is a vitally important decision for any family, and one in which most people have little experience with or are ill prepared for. But you and your referred patients can take comfort in the fact that Med Plus HealthCare is a name well-known and trusted by hundreds of physicians, medical facilities and patients throughout the Midwest.
And you can recommend Med Plus HealthCare with confidence, as we only hire the most qualified medical professionals in their respective medical and therapy disciplines. Throughout your patient’s healthcare service, our team members are dedicated to providing professional and compassionate care, tailored to meet their individual healthcare needs, in the comfort, safety and privacy of the patient’s home.
We deliver appropriate, high-quality home health care and believe it is our mission to treat every patient with genuine kindness, compassion and the respect they deserve. We take great pride in the fact that our patient outcomes are significantly higher than national standards. In addition to Medicare/Medicaid we also work with a wide variety of private insurance providers, especially now that so many employers are offering home health care insurance.
We are also pleased to now provide our physicians with the convenience of our new web-based, HIPPA-secure and Medicare/Medicaid approved electronic signature and referral system “ Physician Link.” Instead of faxing, mailing or taking time away from your patient population to meet a courier, you’ll now be able to sign the Plans of Care and verbal orders electronically. In addition, the system allows your office staff to electronically transmit new referrals directly to our agency. There is no cost to this service and it allows you and your staff the opportunity to create additional efficiencies within you office.
THE THREE COMPONENTS OF PHYSICIAN LINK
The Approve Link section gives you and your approved office staff 24/7 access to view and electronically sign orders sent from Med Plus Healthcare for your patients, from any Internet connection worldwide. It also features a handy timer that tracks the time spent reviewing individual orders by you or your staff, making your office record keeping for reimbursement that much easier.
When ready to approve the order, with a click of the Approve button our records at Med Plus Healthcare will be instantly updated, moving the order from the Approve section to the History section of Physician Link. You can also select view-all mode to see every pending order, and Approve of all unsigned orders at once with a click of the mouse, or view them individually in one-at-a-time mode.
You and your office staff can quickly and conveniently enter and transmit new referrals to Med Plus Healthcare. You and your approved office personnel can key in as little or as much of the patient data as known or desired. The only required fields to get started are patient name and phone number.
A simple click of the Submit Referral button transmits the referral directly to Med Plus Healthcare via a HIPAA-secure, Medicare and Medicaid-approved, encrypted protocol. Which again, offers an efficient and convenient way of referring patients.
The History Link section provides you and your staff 24/7 access to all previously signed orders for each patient in the system, for review or for printing.
Physician Link provided by Med Plus Healthcare is an innovative online tool which will save you time, money and increase the efficiency of your staff. Please contact us at Med Plus Healthcare to find out more about how this unique web portal can benefit you and your patients, and I am always available to come to your office and personally introduce myself and company in hopes of having the opportunity of partnering with you to serve the needs of your patients in the home.
Rick Rief, President/CEO Med Plus Healthcare
November was home care and hospice awareness month, a topic that couldn’t be more important to millions of aging Baby Boomers. Many Boomers have decided to buy long-term care insurance after seeing parents and in-laws unable to qualify for government benefits for their home healthcare, assisted living, nursing home or hospice care, and their families have ended up responsible for his or her care.
Most are determined to spare their children from that experience, and for good reason. Currently home care and hospice organizations take care of more than 12 million people a year, a number sure to rise significantly in the years and decades ahead. Home care can include many things, such as nurses monitoring patients’ health care needs, physical, occupational and speech therapy and nutrition consultation. Hospice care is designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to treatments.
One of the primary fears for many Boomers is that long-term care insurance will become unaffordable in the future. For example, John Hancock, which has a contract with the U.S. Office of Personnel Management (OPM) to provide long-term care insurance for federal employees, recently asked state regulators for an average rate increase of 40% on most of its Non-Federal long-term care insurance policies. So when the five year deal struck with the OPM has to be renegotiated, even former Federal employees are concerned that their rates could skyrocket. Other major players, such as Genworth and Bankers Life and Casualty, have also asked state regulators for rate increases of 30% or more.
Why is this? The same factors that have highlighted the need for long-term care insurance anda rapidly aging population, lengthening longevity and unpredictable health care costs and have made it increasingly unprofitable for insurers.
In addition to health care hyper-inflation, insurance companies are also struggling with record low interest rates on investments, which have dragged down returns. These sustained low interest rates are a game changer for the long-term care insurance industry, having a similar effect as $4-a-gallon gas has to the SUV market, experts say.
And of those insurers who have not raised rates, some have left the business altogether, reducing competition and choice. Earlier this month, MetLife announced that it will stop selling long-term care insurance. The company said it will continue to provide coverage to existing policyholders. “While this is a difficult decision, the financial challenges facing the LTCI industry in the current environment are well known,” Jodi Anatole, vice president of long-term care products for MetLife, said in a statement.
So millions of aging Baby Boomers now face a similar concern and long-term care insurance is supposed to protect seniors and their families from the soaring costs of nursing home and home-based health care – but may become unaffordable in the future.
Policy makers are also acutely aware of the significant impact of long-term care insurance and home healthcare in the marketplace. Not only is it highly preferred by patients, with better outcomes than any other option, but the Kaiser Family Foundation also reports that the increased use of long-term care insurance would also reduce the burden on Medicaid, which currently accounts for about 43% of the cost of nursing home care used in the place of home healthcare.
Who Needs Long Term Insurance, And What To Look Out For
Wealthy Boomers have sufficient assets to pay for long-term care, and low-income Boomers will probably be eligible for federal assistance. But for the vast swath of graying middle-income Boomers, long-term care insurance fills an important vacuum, industry representatives say.
Medicare doesn’t cover long-term care, and Medicaid kicks in only after you’ve exhausted most of your assets. In addition, relying on Medicaid will sharply reduce your options for long-term care, says the AARP.
No surprise to most, AARP research shows that the vast majority of Boomers like where they’re living and are opposed to nursing home care. And Medicaid doesn’t typically pay for home health care. Most long-term care policies include coverage for at-home care, and if you need a nursing home somewhere down the line, you won’t be limited to facilities that accept Medicaid patients.
Although you should be aware and careful of possible deceptive practices from insurance companies, there are many benefits to long-term care insurance, especially for Baby Boomers who can’t count on someone to care for them when they can’t take care of themselves.
Groups that should list long-term care insurance as a must have include singles, seniors whose children live far away, and women. Women tend to be the primary caregivers for their parents and spouses and usually outlive their husbands, says Rick Rief, President of Med Plus Healthcare. “By the time you’re 80, you’re worn out, and there’s nobody left to care for you,” he says. And with the recent drop in the financial markets, long-term care insurance begins to take on an even greater importance.
Still, buying long-term care insurance entails some risks. The majority of consumers buy their policies between ages 55 and 64, according to American Association for Long-Term Care Insurance. Even if you wait until you’re in your 60s which will mean higher premiums you could end up paying monthly premiums for 20 years or more before you need long-term care. If your income declines, or premium hikes make your policy unaffordable, you may have to cancel your policy, wiping out your investment. And if you live independently until you’re 95, then die in your sleep, you won’t get anything back for your investment.
Currently, there’s a wide variation in premiums for long-term care. Premiums for policyholders ages 55-64 range from $1,257 to $3,075 a year, according to the AALTC. The average premium for that age group is $2,200 a year. Average premiums for individuals age 65 and older are $3,250. By the time seniors reach their mid-70s, most policies are unaffordable or unavailable.
Ways To Keep Your Premiums Affordable
Opt for time-limited benefits. The biggest rate increases have been for older policies that provided no cap on the number of years they’d cover. Consumers can lower premiums by up to 39% a year by buying a policy that limits coverage to three years, says Mr. Rief. For most people who are in good health, three years of coverage is sufficient, added Rief. “Most of the cost of the health care system is incurred in the final year of life,” he says.
Include a waiting period. Like a higher deductible on your car insurance, a 90-day waiting period will lower your premiums. Most people can rely on family and friends to help out until their coverage kicks in, he says.
Remember, too, that if you require long-term care because of a stroke, broken hip or similar affliction, Medicare will typically cover you for the first 20 days. While some insurers sell coverage that takes effect immediately, that’s a luxury few can afford and protection most won’t need,” Rief says.
Research the history of rate increases. Med Plus Healthcare recommends asking insurers: When was your last rate increase, and how many increases have you had in the last 10 years? You can also get that information from your state’s department of insurance. Your state insurance department can also tell you if there have been a lot of complaints about the insurer. To find your state’s insurance department, go to www.naic.org.
Stick with established companies. It may be a long time before you need long-term care, so you want an insurer that will be around at least as long as you will. Med Plus Healthcare also recommends buying from companies that sell other insurance products, such as annuities and life insurance. Those companies are better able to withstand short-term losses in their long-term care policies.
They may also be more expensive. Jack Reynolds, 61, of St. Charles, Mo., says he pays a higher premium for his policy from Northwestern Mutual than he could have gotten elsewhere. But Northwestern Mutual hasn’t increased its rates since it started offering policies in 1998. Reynolds believes that’s because the company has accurately projected the cost of claims.
Get help. Long-term care insurance can be extraordinarily complicated. There are no standard options you can compare on the Internet. Policies may cover nursing home care and assisted living, in addition to home care, or offer a combination of services. Some will pay a family member to care for you; others require you to hire a certified health professional. Some policies will pay you a lump sum to use however you want, once you’re eligible for coverage.
Policies also have different “triggers” that must transpire before your coverage kicks in. Generally, insurers require that you need assistance with at least two “activities of daily living (ADLs),” such as bathing, eating or walking. Unscrupulous insurers sometimes exploit ambiguity over ADLs to deny claims, Rief says.
Consult with an insurance agent or broker who specializes in long-term care insurance and can help you identify a policy that will fit your income and needs. Even then, you may want to have an attorney review your policy before you sign up, because this is definitely one of those times when you want to be a very wise consumer and spend the time to read all the fine print.
What is Home Healthcare?
Some patients don’t even know that home healthcare is an option when considering other arrangements, such as rehab centers, assisted living facilities, nursing homes or even some hospice care.
Home care staff work closely with doctors, and can come as often as every day or just once in a week. They can help with all sorts of medical requirements, such as – bandage changes or wound care, medication monitoring, physical and occupational therapy, speech pathology – all done by your home health nurses.
Your home health nurse may know that an expensive medication you’ve been prescribed can be found from another source for less, or can alert you, your family and applicable physicians if different doctors have prescribed the same medication(s), or prescribed medicines that may conflict with one another. This can be especially important as today’s seniors are taking many different medications, and may not even completely understand what they are taking.
Your nurse may also be able help with the underlying condition that caused the acute problems in the first place, such as helping a diabetic amputee not only with their prosthesis, but also assistance getting their disease under better control with diet and other lifestyle changes, allowing you to manage your diabetes with pills instead insulin.
“We’re here to keep people in their own homes,” Rief said. “They do so much better at home, and our goal is help people become as independent as possible, as soon as possible.
An effort to develop a treatment for Alzheimer’s disease was halted after data showed that a new drug was doing more harm than good, leading to more memory loss and putting people at a higher risk for skin cancer.
Judy Woodruff from PBS discusses the findings with Dr. Paul Aisen of the University of California, San Diego.